Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
College of Medicine, University of Central Florida, Orlando, Florida, USA.
Otolaryngol Head Neck Surg. 2020 Jun;162(6):839-852. doi: 10.1177/0194599820913533. Epub 2020 Mar 24.
To compare the effectiveness of transoral robotic surgery (TORS) versus plasma ablation (PA) in tongue base reduction surgery for obstructive sleep apnea (OSA).
PubMed, Scopus, Cochrane Library, OVID.
Keywords searched included OSA, tongue base surgery, TORS, and coblation. Outcomes included pre- to postoperative apnea-hypopnea index, Epworth Sleepiness Scale (ESS), and lowest oxygen saturation. Additional outcomes included surgical success rate, postoperative bleeding, operative time, and length of stay.
A total of 690 unique articles were identified, of which 60 underwent full-text review. Twenty-six articles were included in final analysis, comprising 18 studies on TORS (834 patients) and 11 studies on PA (294 patients). Mean differences of apnea-hypopnea index, ESS, and lowest oxygen saturation for TORS were -23.92, -7.6, and 5.83% (all < .01). Corresponding values for PA were -22.07, -4.14, and 5.48% (all < .00001). TORS had greater ESS reduction than PA ( = .02). Follow-up duration was shorter in TORS than PA (mean ± SD: 4.2 ± 2.6 vs 4.6 ± 1.4 months, = .0482). Surgical success rates in TORS and PA were similar (57.6% vs 60.3%, = .4474). Postoperative bleeding occurred less frequently in TORS versus PA (3.3% vs 7.5%, = .0103). Operative time was longer for TORS than PA (77.9 ± 16.4 minutes vs 44.0 ± 12.9 minutes, < .0001). Length of stay was similar between TORS and PA (3.9 ± 1.6 days vs 3.9 ± 2.5 days, = .9047).
Tongue base reduction with TORS or PA each effectively treats OSA and provides comparable results. The choice between techniques might depend on patient factors, availability of technology, and associated costs.
比较经口机器人手术（TORS）与等离子消融（PA）在舌骨下缩小手术治疗阻塞性睡眠呼吸暂停（OSA）中的疗效。
PubMed、Scopus、Cochrane 图书馆、OVID。
检索的关键词包括 OSA、舌骨下手术、TORS 和电切术。结果包括术前至术后呼吸暂停低通气指数、Epworth 嗜睡量表（ESS）和最低血氧饱和度。其他结果包括手术成功率、术后出血、手术时间和住院时间。
共确定了 690 篇独特的文章，其中 60 篇进行了全文审查。26 篇文章被纳入最终分析，其中 18 篇关于 TORS（834 例患者）和 11 篇关于 PA（294 例患者）的研究。TORS 的呼吸暂停低通气指数、ESS 和最低血氧饱和度的平均差异分别为-23.92、-7.6 和 5.83%（均<.01）。PA 的相应值分别为-22.07、-4.14 和 5.48%（均<.00001）。TORS 比 PA 有更大的 ESS 降低（=.02）。TORS 的随访时间短于 PA（平均±SD：4.2±2.6 与 4.6±1.4 个月，=.0482）。TORS 和 PA 的手术成功率相似（57.6%比 60.3%，=.4474）。TORS 术后出血较 PA 少（3.3%比 7.5%，=.0103）。TORS 的手术时间长于 PA（77.9±16.4 分钟比 44.0±12.9 分钟，<.0001）。TORS 和 PA 的住院时间相似（3.9±1.6 天比 3.9±2.5 天，=.9047）。
TORS 或 PA 进行舌骨下缩小术均能有效治疗 OSA，且疗效相当。技术选择可能取决于患者因素、技术可用性和相关成本。
